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April 26, 2021

Women in Stroke Trials—A Tale of Perpetual Inequity in Cardiovascular Research

Author Affiliations
  • 1Department of Medicine, West Virginia University, Morgantown
  • 2Division of Cardiology, Johns Hopkins School of Medicine, Baltimore, Maryland
JAMA Neurol. 2021;78(6):654-656. doi:10.1001/jamaneurol.2021.0624

“We cannot all succeed when half of us are held back.”

Malala Yousafzai, activist

Historically, scientific, socioeconomic, cultural, and institutional barriers have restricted the inclusion of women in clinical trials. Scientific conundrums, such as safety concerns for mothers and offspring, limited the enrollment of women of childbearing age in early-phase drug trials.1,2 Women were viewed to be potentially confounding and more expensive research participants because of their fluctuating hormone levels,1,3 while white male participants were considered the normative study population.1,4 It was just assumed that women would share an identical response to treatment with men.3 Consequently, early scientific research was primarily focused on men, leaving behind an incremental knowledge gap on sex-based clinical differences.5

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